Healthcare Provider Details

I. General information

NPI: 1245938174
Provider Name (Legal Business Name): MONICA MARIA GILLESPIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2023
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8331 BUCHANAN AVE
SAINT LOUIS MO
63114-6213
US

IV. Provider business mailing address

542 AMHERST ST STE B
NASHUA NH
03063-1016
US

V. Phone/Fax

Practice location:
  • Phone: 314-397-4337
  • Fax:
Mailing address:
  • Phone: 844-923-4222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2021018947
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133002973
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: